胃と腸53巻2号

2018年02月発行

今月の主題 IBDの内視鏡的粘膜治癒─評価法と臨床的意義 主題

炎症性腸疾患における粘膜治癒と長期経過

著者： 久松理一¹ 林田真理¹ 櫻庭彰人¹ 齋藤大祐¹ 三浦みき¹ 三井達也¹ 池崎修¹ 箕輪慎太郎¹ 佐藤太龍¹ 徳永創太郎¹ 菊地翁輝¹ 森久保拓¹

所属機関： ¹杏林大学医学部第三内科学

ページ範囲：P.157 - P.162

要旨●IBDの診療に長期予後の改善を目的としてtreat to targetのコンセプトが導入され，内視鏡的寛解（粘膜治癒）が治療目標として設定された．粘膜治癒の概念は臨床試験のみならず日常臨床にも普及しつつあり，粘膜治癒の達成が長期予後に相関するというエビデンスも蓄積しつつある．一方で，潰瘍性大腸炎では臨床症状がなくても内視鏡的活動性のみで治療介入するのか，Mayo内視鏡サブスコア＝0を目指すべきなのかといった課題，Crohn病では内視鏡的評価の妥当性や利便性など解決すべき課題も残されている．

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